Incidence, Prevalence, and Risk Factors of Hemiplegic Shoulder Pain: A Systematic Review

Int J Environ Res Public Health. 2020 Jul 9;17(14):4962. doi: 10.3390/ijerph17144962.


The current systematic review aimed to investigate the incidence, prevalence, and risk factors causing hemiplegic shoulder pain (HSP) after stroke. Two independent authors screened titles and abstracts for the eligibility of the included studies in the electronic databases PubMed and Web of Science. Studies which reported the incidence, prevalence, and risk factors of HSP following stroke were included. The included studies were assessed using the Newcastle-Ottawa Scale for evaluating the quality of nonrandomized studies in meta-analyses. Eighteen studies were included in the final synthesis. In all studies, the number of patients ranged between 58 and 608, with the mean age ranging from 58.7 to 76 years. Seven included studies were rated as "good "quality, while one study rated "fair" and 10 studies rated "poor" quality. Eight studies reported incidence rate while 11 studies reported the prevalence of HSP following a stroke. The incidence of HSP was ranging from 10 to 22% in the metanalysis of the included studies. The prevalence of HSP was ranging from 22 to 47% in the metanalysis of the included studies. The most significant predictors of HSP were age, female gender, increased tone, sensory impairment, left-sided hemiparesis, hemorrhagic stroke, hemispatial neglect, positive past medical history, and poor National Institutes of Health Stroke Scale score. The incidence and prevalence of HSP after stroke vary considerably due to various factors. Knowledge of predictors is important to minimize the risk of developing HSP following a stroke.

Keywords: hemiplegic shoulder pain; incidence; pain; prevalence; risk factors; stroke.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Aged
  • Female
  • Hemiplegia* / epidemiology
  • Hemiplegia* / etiology
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors
  • Shoulder Pain* / epidemiology
  • Shoulder Pain* / etiology
  • Stroke* / complications
  • Stroke* / epidemiology